Evaluation of the Rapid Re-Housing for Homeless Families Demonstration Program

RAPID RE-HOUSING FOR HOMELESS FAMILIES DEMONSTRATION STUDY
Participation Agreement
The US Department of Housing and Urban Development (or HUD) is studying the Rapid
Re-Housing for Homeless Families Demonstration Program – the type of program
currently providing you with rental assistance and supportive services. The FY 2008
budget for the U.S. Department of Housing and Urban Development (H.R. 2764)
included funding to support this program, and required the Department to evaluate the
effectiveness of the rapid re-housing approach in addressing the needs of homeless
families. Abt Associates (Abt) and AbtSRBI, research and survey firms, are helping
HUD with the study.
We invite you to participate in this study. If you participate, you will help HUD and your
community learn more about how well the Rapid Re-Housing approach works so they
can make good decisions about how to help homeless families in the future.
Participating in this study is voluntary, which means that you do not have to participate if
you do not want to. If you decide to participate, you will be one of around 1,200 families
from 23 communities helping HUD learn how well this type of program works. If you
decide not to join the study, nothing will change about the assistance you receive from
this program.
What do I need to do to participate in this study?
To join the study, you will need to sign this Participation Agreement and provide
information about how we can get in touch with you in the future.
What happens once I agree to participate?
If you decide to participate, someone from Abt will contact you to interview you about 12
months after you finish receiving help from the Rapid Re-Housing program. The
interview will take around 25 minutes. The interviewer will ask you questions about your
housing; barriers you’ve faced keeping your housing; your income, benefits, and work
experience; your health. The interviewer will also ask about people who are part of your
family, including questions about your children, their school attendance, and foster care
involvement. When you are contacted for the follow-up survey, you can choose not to
participate in the survey if you have changed your mind. And even if you participate in
the survey, you can choose not to answer any question. All information you provide will
be kept confidential to the extent allowed by law. You will be given $25 as a way of
thanking you for the time needed to complete the interview.
At the end of this form, we will be asking you to write down your contact information,
information for your landlord, and contact information about others who are likely to
know how to reach you in the future. Agreeing to participate in the study means that
you give us permission to contact you for this interview and, if needed, to contact the
other people you tell us about in case you have moved and we need help finding you for
the follow-up interview.

RAPID RE-HOUSING FOR HOMELESS FAMILIES DEMONSTRATION STUDY
Participation Agreement
Agreeing to participate also means that you give the program staff and researchers
permission to use information that was collected about you by this program or other
homeless programs in this community to understand how the Rapid Re-Housing
assistance worked.
Who will see the information I provide?
All information you share with us and all of information we collect from the Rapid ReHousing program or any other programs about you is confidential. Your information will
be protected to the extent allowed under the law as part of the Privacy Act.
 Only the interviewer and a small number of research staff at Abt and SRBI
authorized to work on this research study will see your identifying information and
the other information about you that we collect.
 A few other authorized researchers will have access to your individual information,
but not your name, address, date of birth, or social security number.
 No one at the Rapid Re-Housing program, any other local agency, or HUD will see
your interview responses.
 Reports for this study will only discuss summary information about groups of families
who have received assistance. No names or other identifiers will ever be used in
any research report.
Are there any risks to me if I participate in this study?
The risks to you of participating in this study are minimal. However, if you join, there are
some potential risks. Risks could include the possibility that:
 You might be uncomfortable or even upset answering some of the questions on the
interviews. If you feel that way, you can choose not to answer any question on any
of the surveys. You can also stop the interview at any time.
 There is a remote risk that your information could be obtained by someone other
than the authorized researchers doing this study. We have strict procedures in place
to protect the information you provide and to help prevent this from happening.
Questions About Participation
If you have questions regarding this study, please contact the Abt Associates Inc.
Project Director, Ms. Brooke Spellman at (301) 634-1816. You may also contact Ms.
Anne Fletcher at the U.S. Department of Housing and Urban Development at (202) 4024347. These numbers are not toll-free calls. You may have to pay for these calls.
If you have questions about your rights as a participant in this study, please contact Ms.
Teresa Doksum from the Institutional Review Board at Abt Associates toll-free at 877520-6835.

RAPID RE-HOUSING FOR HOMELESS FAMILIES DEMONSTRATION STUDY
Participation Agreement
Directions
If you are willing to participate in the study, please sign below and work with a staff
person from the Rapid Re-Housing program to record the requested contact
information.
By signing this participation agreement, I confirm that I have read and understand the
information presented in it. The information in this form has also been explained to me.
I have had the opportunity to ask questions. I understand that my participation is
voluntary, and I can ask to be withdrawn from the study at any time. I understand that I
will be given a signed copy of this consent form to keep. I voluntarily agree to take part
in this study of rapid re-housing for homeless families programs.
_______________________________________________
Participant’s Signature

____________________
Date

Participant Contact Information
First Name

Middle Initial

Last Name

Suffix

Date of Birth

Social Security
Number

Street Address

Apt #

City

State

Zip Code

Email

Home Phone

Mobile Phone

Landlord Contact Information
Landlord’s
Name
Address (where
rent is paid)

Company
Name

State

Zip Code

Work Phone

Mobile Phone

City

On the following page, please provide contact information for 2 to 3 people who do not
currently live with you and will always know how to reach you.

RAPID RE-HOUSING FOR HOMELESS FAMILIES DEMONSTRATION STUDY
Participation Agreement
Privacy Act Statement: HUD’s authoritative and principle purpose, conditions of uses, and impacts, if any, for not
participating in the survey are referenced within the participant agreement.

Contact Information for a Friend or Relative
(Someone who does not live with you and will always know how to contact you)
First Name
Relationship

Last Name
 Friend

Specify type of
Relative

 Relative

Street Address

Apt #

City

State

Zip Code

Email

Home Phone

Cell Phone

Contact Information for a Friend or Relative
(Someone who does not live with you and will always know how to contact you)
First Name
Relationship

Last Name
 Friend

Specify type of
Relative

 Relative

Street Address

Apt #

City

State

Zip Code

Email

Home Phone

Cell Phone

Contact Information for a Friend or Relative
(Someone who does not live with you and will always know how to contact you)
First Name
Relationship

Last Name
 Friend

 Relative

Specify type of
Relative

Street Address

Apt #

City

State

Zip Code

Email

Home Phone

Cell Phone

RRHD Program Information (To be completed by RRHD Program Staff Person)
RRHD Site

RRHD Agency

RRHD Entry Date

RRHD Exit Date
(if known)

Date Form was
Completed

Timeframe Form
was Completed

 At RRHD Program Entry
 At RRHD Program Exit
 Other